Before - After pictures
Scar-correction
All tissue heals with scars, but the appearance of scars and behavior are different. Ideal is the so-called biological scar, which is thin-lined, light and unobtrusive, with soft, almost unvisible, the function only slightly or not at all disruptive scar tissue. Arise in such a smooth, sharp incision, after which supply clean (aseptic) environment, good technique.
The process of wound healing and the appearance of scars resulting from the quality of skin, depends on the direction of the incisions. In contrast, the body is determined at every point in a direction (the so-called dynamic lines of force), which is located along scarlines, then scars are ideal thin, soft lines. This is the so-called. "Biological scars" to be sought.
If the above does not take place, abnormal scars may result. The scar is a necessary replacing tissue. They are weaker, mechanical stress does not have a rigid, inflexible, elongation, may be painful. Formation of direction is not always apparent in advance.
Three forms: A. atrophic, B. hypertrophic C. keloid:
A atrophic scars.> Thin, the epithelium covering the scar, is easy to remove, vulnerable, poor circulation due to sunken areas. The surrounding tissue anchors, operation limits, so they waste away. Mainly occurs after extensive burns. Management: to be removed early while it does not cause irreversible damage to uderlaying or surrounding tissue.
B hypertrophic scars.. The original boundaries of tissue defect not exceeding the limit, without sharp edges melted into environment. Does not grow back over time, even develop. Atrophied epithelium surface. No anchoring in the surrounding tissues. Outstanding, atrophic scar-islands in it, is less damaging to the environment. Treatment: removing (excisin) in the sleeping-phase, not too early or too late.
C. keloid. Incision after surgery or injury, or spontaneous abnormal scar tissue, benign growth, connective tissue tumor considered. The skin layer formed by a sharp-edged, pearlescent coverage, exceeds the limits of the original tissuedefect, uneven edge. Candles-drop emerges, there is no tendency to spontaneous healing. Symptoms: pain, itching, burning sensation, deformity. Its origin is unknown. Interference with the skin (injection, surgery, accident), but also occur spontaneously. Hormonal factors also play a role in the development (puberty, pregnancy are more frequent, less frequent in old age). Is more common in humans with colored skin.
Most common place of occurrence on the shoulder, above the sternum, chest, arms, ears, earlobes. Initial symptoms of itching, redness, skin tight, and padded to become prominent, the appendages disappear, painful pressure. Malignant transformation is not clear.
Treatment: steroids (Kenalog) injection used locally. Surgical excision alone is not an option, because within 2 years, nearly 40% of cases it returns. (The Surgical Clinics of North America, June 1997, 77: 3, 509-528, 575-586, 587-606)
The currently accepted treatment is surgical excision and subsequent combination of x-ray irradiation. If there is no possibility to close the wound without tension, skin grafting (split skin thickness) is rekommended. The x-ray irradiation have to be started within 24 hours after the surgery, this empirical fact, the cause is not known. .
Complications: in the irradiated areas of excessive hyperpigmentation. The result of freezing treatment: atrophic scars.
